Core outcome set development for intervention research on snakebite in South Asia: methodological case study

Article type
Authors
Bhaumik S1, COS-Snakebite-South-Asia-Group .2
1Meta-research and Evidence Synthesis Unit, The George Institute for Global Health
2.
Abstract
Background:
Core outcome set (COS) are a consensus-derived set of outcomes that should be minimally measured in future research or practice for a specific condition. A COS for intervention research on snakebites in South Asia was developed, and several new methodological insights were obtained.

Objectives:
To describe and discuss methodological insights obtained from COS development on snakebites in South Asia.

Methods:
A case-study approach is being taken, wherein the COS development process is described in brief together with methodological insights for future methods work.

Results:
The COS development process involves results from a systematic review to develop an initial list of outcomes for a Delphi survey to develop COS for five intervention groups. The two-stage Delphi survey involved healthcare providers, patients and the public, and potential COS users. This was followed by a final consensus meeting and workshops to finalise “what” and “how” outcomes in COS should be measured in future. Insights around setting scope (global versus regional), modular design of Delphi, and several challenges for patient and public involvement (most people with a snakebite have poor literary, and there are no organised survivor groups).

Conclusions:
The case study suggests the need for revising the current COS-STAndards for Development (STAD) with more nuanced standards, in relation to scope, and stakeholder involvement thresholds. It also indicates the need for developing guidance on modalities for patients and public engagement for disease conditions for which no organised survivor groups exist and in populations in which literacy is poor.

Patient and public involvement:
Snakebite patients, their caregivers, and community representatives were involved in the COS development process.